ECMO-/ECLS

 Clinical characteristics: 100 times more potent than morphine.

most hemodynamically stable opioid

 Dosing: 1 mcg/kg

o sufentanil: fentanyl derivative that is 10x more potent

than fentanyl. Used commonly in cardiac anesthesia.

 Doses of 15-30mcg/kg

o remifentanil: extremely short half life. Used as

continuous infusion only. 10x as potent as fentanyl

 Onset and elimination: rapid onset: <1 minute; brief duration

30 - 45 minutes. Half life 8 hours

 Precautions:

o glottis and chest wall rigidity following rapid infusion of

> 5mcg/kg

o bradycardia

3. Methadone [13]
    Clinical indications: used to treat or wean opioid addicted or
   dependent patients. Post op pain relief
    Clinical effects: high oral bioavailability (90%). Full analgesic
   effect 3-5 days after initiating dosing.
    Dosing: load dose: 0.1-0.2 mg/kg IV; titrate in 0.05mg increments
   every 4-12 hours
   o conversion morphine to methadone - 1: 0.25